Child's Full Name
*
Child's Date of Birth
*
Child's Gender
*
Male
Female
Child's Allergies (for snacks)
*
Notes about child (optional)
Please enter Parent information below
First Name
*
Last Name
*
Cell Phone
*
Text Opt In
By checking this box I agree to receive email and SMS text communications and promotions from Discovery Place Preschool about 1 message a month. SMS text and data rates may apply. I may opt out at any time by replying STOP. View Terms and Conditions at https://discoveryplacestanwood.com/privacy
Email
*
Address
*
City
*
State
*
Zip code
*
2nd Parent Full Name
2nd Parent Cell Phone
In addition to those listed above, the following individuals may pickup my child:
Authorized Adult 1 Full Name
Authorized Adult 1 Phone
Authorized Adult 2 Full Name
Authorized Adult 2 Phone
Authorized Adult 3 Full Name
Authorized Adult 3 Phone
